| Trinity Family Medical Center, Pa | |
|
1707 Mayo Drive Tavares FL 32778 | |
| (352) 253-2511 | |
| (352) 253-2522 |
| Full Name | Trinity Family Medical Center, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1707 Mayo Drive, Tavares, Florida |
| Authorized Official Name and Position | Stephen E Young (OWNER) |
| Authorized Official Contact | 3524834837 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trinity Family Medical Center, Pa Po Box 490 Eustis FL 32727-0490 Ph: (352) 253-2511 | Trinity Family Medical Center, Pa 1707 Mayo Drive Tavares FL 32778 Ph: (352) 253-2511 |
| NPI Number | 1598782401 |
|---|---|
| Provider Enumeration Date | 07/16/2006 |
| Last Update Date | 04/29/2009 |
| Medicare PECOS PAC ID | 1456384825 |
|---|---|
| Medicare Enrollment ID | O20050915000758 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598782401 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 059170 (Florida) | Primary |
| Provider Name | Stephen Earl Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306844964 PECOS PAC ID: 4587622006 Enrollment ID: I20041229000830 |
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